NPIMap

Organization Active NPI

Signature Smiles, LLC

  • Dentist
  • Columbia, SC
National Provider Identifier
1104304393
Registry record updated Jul 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6903 Issued in SC
Legal business name
SIGNATURE SMILES, LLC
Practice address
1730 Henderson St Ste a
Columbia, SC 29201-2648
Phone
(803) 252-5068
NPI assigned
Jul 31, 2018
Last updated
Jul 31, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Blake Michael Julian, MDNPI 1477865004
Title
Practice Owner
Phone
(864) 271-6213

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 6903 SC Primary

Addresses

Primary practice location

1730 Henderson St Ste a
Columbia, SC 29201-2648

Mailing address

1730 Henderson St Ste a
Columbia, SC 29201-2648
Phone (803) 252-5068

National Provider Directory

National Provider Directory
Tax ID family
Signature Smiles LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1730 Henderson St
Ste A
Columbia, SC 29201
Phone (803) 252-5068

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1532995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532995200000",
    "number": "1104304393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 HENDERSON ST STE A",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012648",
            "telephone_number": "803-252-5068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 HENDERSON ST STE A",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292012648",
            "telephone_number": "803-252-5068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIGNATURE SMILES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-31",
        "last_updated": "2018-07-31",
        "status": "A",
        "authorized_official_last_name": "JULIAN",
        "authorized_official_first_name": "BLAKE",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRACTICE OWNER",
        "authorized_official_telephone_number": "864-271-6213",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "SC",
            "license": "6903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.